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03-09-2012 | Article

The week in review, August 26-September 1, 2012

medwireNews: This week's headlines featured burned-out physicians, bad and worse news about the West Nile virus (WNV) outbreak and hantavirus infections among Yosemite campers, and the Department of Health and Human Services (HHS) goes on the record about electronic health records and gets into the app sponsorship game.

Doc burnout 'alarming'

Of 7288 physicians who responded to a survey, nearly half (45.8%) reported at least one symptom of burnout, such as emotional exhaustion, low sense of personal accomplishment, or depersonalization (detachment), report Tait Shanafelt (Mayo Clinic, Rochester, Minnesota) and colleagues online in Archives of Internal Medicine.

Emergency department physicians, general internists, family medicine practitioners, and neurologists were most likely to report burnout symptoms, whereas pathologists, dermatologists, general pediatricians, and preventive medicine specialists tended to be the least affected by the scope and pace of their work, the investigators report.

"Collectively, the findings of this national study indicate that (1) the prevalence of burnout among US physicians is at an alarming level, (2) physicians in specialties at the front line of care access (emergency medicine, general internal medicine, and family medicine) are at greatest risk, (3) physicians work longer hours and have greater struggles with work-life integration than other US workers, and (4) after adjusting for hours worked per week, higher levels of education and professional degrees seem to reduce the risk for burnout in fields outside of medicine, whereas a degree in medicine (MD, or DO) increases the risk," they write.

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West Nile virus swarms across the USA

The current WNV outbreak is one of the largest ever seen in the USA, according to the Centers for Disease Control and Prevention (CDC).

As of August 28, the CDC had confirmed 1590 reported cases and 66 deaths. Of the 1590 infections, 889 led to neuroinvasive disease, and 701 to non-neuroinvasive disease. The number of cases increased by 40% from the second to the third week of August, and on August 22, the CDC reported 1118 human cases of WNV and 41 deaths.

Nearly half of the cases (733) occurred in Texas, with the Dallas-Fort Worth area being the hardest hit, said Lyle Petersen, director of the CDC's division of vector-borne infectious diseases, in a briefing.

Petersen said that the total number of cases are on track to match those of the record years of 2002 and 2003. In each of those years, nearly 3000 cases were reported, and more than 260 deaths were attributed to WNV infections.

"It looks like it is going to be our worst year ever. As I look at the data, I'm not convinced we have peaked," said David Lakey, commissioner of the Texas Department of State Health Services.

The outbreak appears to have been exacerbated by the current climate cycle, in which heavy spring rains were followed by drought in much of the nation, allowing mosquito breeding pools to remain intact instead of being washed away in periodic showers.

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Hantavirus haunts Yosemite

In other unwelcome pest-related news, there have been three confirmed cases and one suspected case of hantavirus pulmonary syndrome (HPS) among people who stayed in rented tents or cabins in Yosemite National Park's Curry Village campground during a single week in June 2012. Two of the patients, both from California, died from the infections, says a statement released by the US National Park Service.

The service's Office of Public Health is attempting to contact approximately 1700 people who stayed in one of the park's "Signature Tent Cabins" at Curry Village from mid-June through the end of August.

According to the CDC, the incubation time for HPS is not well documented, but appears to occur from 1 to 5 weeks after exposure to fresh urine, droppings, or saliva from infected rodents.

Early HPS symptoms are universal and include fatigue, fever, and muscle aches, especially in the large muscle groups - thighs, hips, back, and sometimes shoulders. In approximately half of all patients, infections may also be accompanied by headaches, dizziness, chills, and abdominal symptoms such as nausea, vomiting, diarrhea, and abdominal pain, the CDC says.

The disease has a mortality rate of 38%.

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HHS sweetens the pot for electronic record converters

The US government is giving healthcare providers incentives to comply with new electronic health record (EHR) standards.

Secretary of the HHS, Kathleen Sebelius, announced new rules that she says "will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests, and greater patient engagement in their own care," according to a statement.

Clinicians and hospitals that adopt and "meaningfully use" certified EHR technology can qualify for Medicare and Medicaid incentive payments, according to provisions of the Health Information Technology for Economic and Clinical Health Act.

More than half of all eligible hospitals and 20% of eligible healthcare professionals have qualified to receive incentive payments since the program began in January 2011, the HHS says.

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Apps against cancer

A cool $ 85,000 will be awarded to the software developer who comes up with the best mobile application (app) for narrowing a race and gender disparity in cancer awareness.

The HHS has announced a "Reducing Cancer Among Women of Color App Challenge," the goal of which is to reach women in racial and ethnic minority groups who may not get health information through traditional media, according to an HHS statement.

In 2007, US cancer death rates were higher among African Americans, at 216.3 per 100,000, compared with 177.1 per 100,000 for Whites, according to the National Center for Health Statistics.

The HHS notes that prevalence and mortality rates for breast, cervical, uterine, and ovarian cancer are high among minority and underserved women due to disparities in preventive care, access to early treatment, and quality of care.

"By providing the right information at the right time, mobile apps can help minority and underserved women make informed decisions about their own health, and benefit from the recommended preventive services provided at no cost under the healthcare law," said J Nadine Gracia, HHS acting deputy-assistant secretary for minority health.

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By Neil Osterweil, medwireNews reporter